Long-term outcomes of prostate artery embolization for acute urinary retention: An analysis of 88 patients - 27/05/23
, Olivier Pellerin a, d, Charles Querub a, d, Marc Al Ahmar a, Alessandro Di Gaeta a, Carole Déan a, Paul Meria b, Nicolas Thiounn c, d, Marc Sapoval a, d, Tom Boeken a, d, e
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Highlights |
• | Prostate artery embolization is a valuable option for the treatment of acute urinary retention and can be proposed in case of trial without catheter failure, whatever the clinical conditions and comorbidities, in patients with prostate volume > 50 mL. |
• | Long-term success rates of prostate artery embolization for acute urinary retention is 66%, however relapses affect 15% of patients. |
• | Urological follow-up should be maintained at mid- and long-term in all patients with acute urinary retention successfully treated using prostate artery embolization. |
Abstract |
Purpose |
The purpose of this study was to assess long-term outcome of prostate artery embolization (PAE) in patients presenting with acute urinary retention related to benign prostatic hyperplasia.
Materials and methods |
All consecutive patients who underwent PAE for acute urinary retention due to benign prostatic hyperplasia from August 2011 to December 2021 in a single institution were retrospectively included. There were 88 men with a mean age of 72 ± 12 (standard deviation [SD]) years (range: 42–99 years). Patients underwent a first attempt of catheter removal two weeks after PAE. Clinical success was defined as the absence of acute urinary retention recurrence. Correlations between long-term clinical success and patient variables or bilateral PAE were searched for using Spearman correlation test. Catheter-free survival was assessed using Kaplan-Meier analysis.
Results |
Successful catheter removal in the month following PAE was performed in 72 (72/88; 82%) patients and 16 (16/88; 18%) patients had immediate recurrence. Clinical success persisted for 58 (58/88; 66%) patients at long-term follow-up (mean follow-up: 19.5 months ± 16.5 [SD]; range: 2–74 months). Recurrence occurred at a mean of 16.2 months ± 12.2 (SD) (range: 1.5–43 months) post-PAE. Overall, 21 (21/88; 24%) patients of the cohort underwent prostatic surgery, at a mean of 10.4 months ± 12.2 (SD) (range: 1.2–42.4 months) from initial PAE. No correlations between patients variables or bilateral PAE and long-term clinical success were identified. Kaplan-Meier analysis showed a three-year catheter free probability of 60%.
Conclusion |
PAE is a valuable technique for acute urinary retention related to benign prostatic hyperplasia, with a long-term success rate of 66%. However acute urinary retention relapse affects 15% of patients.
Le texte complet de cet article est disponible en PDF.Keywords : Acute urinary retention, Prostate artery embolization, Prostatic hyperplasia, Bladder outflow obstruction, Long-term outcomes
Abbreviations : AUR, IPSS, PAE, SD, TURP, TWOC
Plan
Vol 104 - N° 6
P. 292-296 - juin 2023 Retour au numéro
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